Article (Scientific journals)
Clinical significance of electrocardiographic markers of myocardial damage prior to aortic valve replacement
Coisne, A.; Ninni, S.; Pontana, F. et al.
2020In International Journal of Cardiology, 307, p. 130-135
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Keywords :
Aortic stenosis; Aortic valve replacement; ECG strain; Myocardial damage
Abstract :
[en] Background: Pre-operative myocardial fibrosis and remodeling impact on outcomes after aortic valve replacement (AVR). We aimed at investigating the prognostic impact of preoperative electrocardiographic (ECG) markers of left ventricular (LV) myocardial damage, i.e. bundle branch block (BBB) and ECG strain pattern after (surgical or transcatheter) AVR for severe aortic stenosis (AS). Methods: Between April 2008 and October 2017, we explored consecutive patients referred to our Heart Valve Clinic for first AVR for severe AS. Detailed pre-operative phenotyping and ECG analysis were performed. Patients were followed-up after AVR for major cardiac events (ME), i.e. cardiovascular death, cardiac hospitalization for acute heart failure and stroke. Results: BBB and ECG strain were respectively observed in 13.5 and 21% of the 1122 patients included. These ECG markers identified a subgroup of older patients, with higher NYHA class and more advanced myocardial disease as detected by echocardiography, i.e. higher LV mass and lower LV ejection fraction, global longitudinal strain and integrated backscatter, than patients without ECG strain or BBB. ME occurred in 212 (18.6%) patients during a mean follow-up of 4.4 ± 1.5 years with higher incidence in case of ECG strain or BBB (HR 1.56, 95%CI 1.13–2.14, p = 0.006; HR 1.47, 95%CI 1.02–2.13, p = 0.04 respectively). The prognostic value of ECG strain remained significant after adjustment for age, diabetes and pre-operative LVEF. Conclusions: Pre-operative ECG markers of myocardial damage identify a subgroup of AS patients at high risk of post-AVR cardiovascular complications irrespective of other prognostic factors and should help the multiparametric staging of cardiac damage to guide AVR. © 2020 Elsevier B.V.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Coisne, A.;  CHU Lille, Department of Clinical Physiology and Echocardiography, France, Univ. Lille, U1011 - EGID, Lille, F-59000, France, Inserm, U1011, Lille, F-59000, France, Institut Pasteur de Lille, Lille, F-59000, France
Ninni, S.;  Univ. Lille, U1011 - EGID, Lille, F-59000, France, Inserm, U1011, Lille, F-59000, France, Institut Pasteur de Lille, Lille, F-59000, France, CHU Lille, Department of Cardiovascular Medicine, France
Pontana, F.;  Univ. Lille, U1011 - EGID, Lille, F-59000, France, Inserm, U1011, Lille, F-59000, France, Institut Pasteur de Lille, Lille, F-59000, France, CHU Lille, Department of Cardiovascular Radiology, France
Aghezzaf, S.;  CHU Lille, Department of Clinical Physiology and Echocardiography, France
Janvier, F.;  CHU Lille, Department of Clinical Physiology and Echocardiography, France
Mouton, S.;  CHU Lille, Department of Clinical Physiology and Echocardiography, France
Ridon, H.;  CHU Lille, Department of Clinical Physiology and Echocardiography, France
Ortmans, S.;  CHU Lille, Department of Clinical Physiology and Echocardiography, France
Seunes, C.;  CHU Lille, Department of Clinical Physiology and Echocardiography, France
Wautier, M.;  CHU Lille, Department of Clinical Physiology and Echocardiography, France
Coppin, A.;  CHU Lille, Department of Clinical Physiology and Echocardiography, France
Madika, A.-L.;  CHU Lille, Department of Clinical Physiology and Echocardiography, France
Boutie, B.;  CHU Lille, Department of Clinical Physiology and Echocardiography, France
Koussa, M.;  CHU Lille, Department of Cardiovascular Surgery, France
Bical, A.;  CHU Lille, Department of Cardiovascular Surgery, France
Vincentelli, A.;  CHU Lille, Department of Cardiovascular Surgery, France
Juthier, F.;  CHU Lille, Department of Cardiovascular Surgery, France
Loobuyck, V.;  CHU Lille, Department of Cardiovascular Surgery, France
Sudre, A.;  CHU Lille, Department of Cardiovascular Medicine, France
MARCHETTA, Stella ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de cardiologie
Martinez, Christophe ;  Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Staels, B.;  Univ. Lille, U1011 - EGID, Lille, F-59000, France, Inserm, U1011, Lille, F-59000, France, Institut Pasteur de Lille, Lille, F-59000, France, CHU Lille, Department of Biology, France
Lancellotti, Patrizio  ;  Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation
Modine, T.;  CHU Lille, Department of Cardiovascular Surgery, France
Montaigne, D.;  CHU Lille, Department of Clinical Physiology and Echocardiography, France, Univ. Lille, U1011 - EGID, Lille, F-59000, France, Inserm, U1011, Lille, F-59000, France, Institut Pasteur de Lille, Lille, F-59000, France
More authors (15 more) Less
Language :
English
Title :
Clinical significance of electrocardiographic markers of myocardial damage prior to aortic valve replacement
Publication date :
2020
Journal title :
International Journal of Cardiology
ISSN :
0167-5273
eISSN :
1874-1754
Publisher :
Elsevier Ireland Ltd
Volume :
307
Pages :
130-135
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 09 July 2020

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